COMPARISON OF ONE VERSUS TWO DRAINS FOR MANAGEMENT OF SEROMA FORMATION IN PATIENTS UNDERGOING MODIFIED RADICAL MASTECTOMY: A QUASI-EXPERIMENTAL STUDY

Abstract

Background: Postoperative seroma represents the most frequent early complication following modified radical mastectomy (MRM), posing significant morbidity, and its persistence can prolong wound healing and postpone the initiation of adjuvant therapy. Objective: To evaluate, in women undergoing modified radical mastectomy for breast carcinoma, whether one axillary drain produces a different incidence of postoperative seroma compared with the placement of two drains. Methods: This quasi-experimental trial study was undertaken at the Surgical Units of the Department of General Surgery, Jinnah Hospital, Lahore from January 2026 and April 2026. Sixty-four patients with biopsy-confirmed breast carcinoma were enrolled and allocated in alternating sequence to Group A, receiving a single axillary suction drain (n = 32), or Group B, receiving two drains placed in the axilla and beneath the mastectomy flap (n = 32). All cases were followed for 30 postoperative days; seroma was diagnosed clinically and confirmed sonographically. Continuous variables were analysed using the independent-samples t-test, and categorical variables using the chi square or Fisher's exact test. Significance was set at p ≤ 0.05. Results: The two arms were comparable for all baseline and intraoperative parameters (p > 0.05). Seroma developed in 8 patients (25.0%) in Group A and 6 patients (18.8%) in Group B, without statistical significance (p = 0.763). Cumulative drain output (423 ± 84.7 vs 460 ± 79.6 mL, p = 0.074) and drain removal day (5.62 ± 2.20 vs 5.42 ± 2.05, p = 0.721) were similar. Postoperative pain on day one was significantly higher in Group B (VAS 4.6 ± 1.4 vs 3.8 ± 1.2, p = 0.018). Conclusion: A single axillary drain after MRM is comparable to dual-drain placement for seroma control while reducing pain and cost.